Perinatal Depressive Symptoms and Viral Non-suppression Among a Prospective Cohort of Pregnant Women Living with HIV in Nigeria, Kenya, Uganda, and Tanzania

AIDS Behav. 2023 Mar;27(3):783-795. doi: 10.1007/s10461-022-03810-6. Epub 2022 Oct 9.

Abstract

Depression is common during pregnancy and is associated with reduced adherence to HIV-related care, though little is known about perinatal trajectories of depression and viral suppression among women living with HIV (WLHV) in sub-Saharan Africa. We sought to assess any association between perinatal depressive symptoms and viral non-suppression among WLWH. Depressive symptomatology and viral load data were collected every 6 months from WLWH enrolled in the African Cohort Study (AFRICOS; January 2013-February 2020). Generalized estimating equations modeled associations between depressive symptoms [Center for Epidemiological Studies Depression (CES-D) ≥ 16] and viral non-suppression. Of 1722 WLWH, 248 (14.4%) had at least one pregnancy (291 total) and for 61 pregnancies (21.0%), women reported depressive symptoms (13.4% pre-conception, 7.6% pregnancy, 5.5% one-year postpartum). Depressive symptomatology was associated with increased odds of viral non-suppression (aOR 2.2; 95% CI 1.2-4.0, p = 0.011). Identification and treatment of depression among women with HIV may improve HIV outcomes for mothers.

Keywords: Africa; Depression; HIV/AIDS; Perinatal; Pregnancy; Viral non-suppression.

MeSH terms

  • Cohort Studies
  • Depression
  • Female
  • HIV Infections*
  • Humans
  • Kenya
  • Nigeria
  • Pregnancy
  • Pregnant Women*
  • Prospective Studies
  • Tanzania
  • Uganda